糖尿病腎病變之中醫治療病例報告

慢性腎臟病在台灣是一項高發生率、高盛行率且高醫療花費之重要疾病。中醫看待慢性腎臟病以症狀表現為基準，自古就有中醫藥治療腎病的諸多紀錄與經驗，對於運用在治療現代人的慢性腎臟病上會有許多幫助。本病案患者為一60歲男性，有高血壓、糖尿病、高血脂病史，於民國98年發現泡沫尿於腎臟科就診，經切片檢查為膜性腎病變及糖尿病腎病變，病情反覆遂於民國102/04/22尋求中醫治療。推測原發性膜性腎病變導致患者腎功能變差，經由症狀推導後有腎陰陽虧虛、肝陽上亢、血瘀熱鬱等證型。治則以補腎益氣利水、養陰化瘀清熱為主，隨證加減。中藥治療後至今，腎功能改善、蛋白尿改善、水腫改善、腰痠改善，持續服藥維持療效。希望本病案可以作為臨床中西醫師做治療慢性腎臟病的參考。

關鍵字

慢性腎臟病；膜性腎病變；糖尿病腎病變；中醫藥

並列摘要

Chronic kidney disease is an significant disease in Taiwan with high incidence, high prevalence and high medical expenses. Chinese medicine treats chronic kidney disease on the basis of symptoms. Since ancient times, there have been many records and experiences of traditional Chinese medicine for treating kidney disease, which can help a lot in the treatment of chronic kidney disease in modern time. The patient was a 60-year-old man with history of hypertension, diabetes, and hyperlipidemia. He visited in our hospital in the Department of Nephrology in 2009. The biopsy was taken and the results showed membranous nephropathy and diabetic nephropathy. Because his condition did not obviously improve, he turned to Chinese medicine Department for help in 2013/04/22. It is speculated that primary membranous nephropathy leads to poor renal function in patients. After the treatment of traditional Chinese medicine, renal function, proteinuria, edema and backache has improved. This case can be used as a reference for the treatment of chronic kidney disease by clinical Chinese and Western doctors.

並列關鍵字

chronic kidney disease ； membranous nephropathy ； diabetic nephropathy ； traditional Chinese medicine

參考文獻

Saran R, Robinson B, Abbott KC, Agodoa LYC, Bhave N, Bragg-Gresham J, Balkrishnan R, Dietrich X, Eckard A, Eggers PW, Gaipov A, Gillen D, Gipson D, Hailpern SM, Hall YN, Han Y, He K, Herman W, Heung M, Hirth RA, Hutton D, Jacobsen SJ, Jin Y, Kalantar-Zadeh K, Kapke A, Kovesdy CP, Lavallee D, Leslie J, McCullough K, Modi Z, Molnar MZ, Montez-Rath M, Moradi H, Morgenstern H, Mukhopadhyay P, Nallamothu B, Nguyen DV, Norris KC, O'Hare AM, Obi Y, Park C, Pearson J, Pisoni R, Potukuchi PK, Rao P, Repeck K, Rhee CM, Schrager J, Schaubel DE, Selewski DT, Shaw SF, Shi JM, Shieu M, Sim JJ, Soohoo M, Steffick D, Streja E, Sumida K, Tamura MK, Tilea A, Tong L, Wang D, Wang M, Woodside KJ, Xin X, Yin M, You AS, Zhou H, Shahinian V: US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2018; 71 (3) (suppl 1): Svii, S1-S672.